Patient: It’s been 2 months since I found out that my chest was swollen and painful, and the test result was T4N3MO. I just finished 2 courses of chemotherapy and took herbal medicine, and now the chest fluid is gone. But it still hurts a little. If chemotherapy doesn’t work, I want to know how to treat it next? If the regression is better (your doctor’s evaluation is CR), continue chemotherapy for two cycles and then supplement radiotherapy, if not, switch to radiotherapy and complete two cycles of chemotherapy after the completion of radiotherapy. If the pleural effusion is badly controlled, the whole pleura can be irradiated if the effect of medical treatment is not good. If the general condition is good, you can do radiotherapy and chemotherapy at the same time, also can be combined with thermal radiotherapy. The economic burden of combining chemotherapy with Endo or other molecular targeting drugs is relatively high (its observation index is “clinical benefit rate” rather than improvement of survival, which means that it is not the first choice when it comes to cost effectiveness), because adenocarcinoma is easier to metastasize than squamous cancer. Because adenocarcinoma is more likely to metastasize than squamous carcinoma, chemotherapy should be given in full courses and at the same dose intensity, but four cycles of chemotherapy is enough. Because we are not sure of the specific situation, it is for reference only. Remember not to forget the “radiotherapy”! If you need further consultation, please upload your images. (Digital photography without flash, try to use a cool light source like daylight or avoid direct sunlight as a background), use the largest size, the more detailed the better.